Catheter

ABSTRACT

Catheters and methods for supporting a guidewire or delivering a radiopaque, diagnostic or therapeutic agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a tip member disposed at a distal end of the shaft body. The shaft body can extend from a proximal end to the distal end and can define an inner lumen. The shaft body can include a liner, a braid member surrounding the liner, a multi-layer coil surrounding the braid member, and a polymer cover surrounding the multi-layer coil. An outer surface portion of the polymer cover can include one or more helical threads, which can be enveloped in an outer wrapper. The tip member can be made from a metal or a polymer. Polymer tip members can include a hard or semi-hard distal tip.

TECHNICAL FIELD

The subject matter of this patent document relates to the field ofmedical devices. More particularly, but not by way of limitation, thesubject matter relates to catheters and methods for supporting aguidewire or delivering a radiopaque, diagnostic or therapeutic agent.

BACKGROUND

A variety of catheters exist for percutaneous insertion into a subject'svascular system to accomplish diagnostic or therapeutic objectives usingthe Seldinger technique. As part of the Seldinger technique, a guidewirecan be inserted through the lumen of a hollow needle and made to enterthe vascular system. A catheter can fit over and slide along theguidewire as it passes through vasculature. The guidewire alone or withthe help of the catheter can be incrementally maneuvered through thevasculature to a target (diseased) site.

Catheters are typically introduced through a large artery, such as thosefound in the groin, neck or forearm, and then passed throughever-narrower regions of the vascular system until reaching the targetsite. Often, such pathways will wind back upon themselves in amulti-looped path. The quest to provide treatment options for narrowingand winding vessels and other lumens has given rise to the need toreduce catheter diametrical size, yet retain a catheter's favorablestructural properties.

OVERVIEW

Various structural properties can be used to describe catheters.“Pushability,” for example, can be used to describe a catheter's axialstrength to facilitate movement of its distal end through vascularpassages or other body lumens by applying an axial pushing force nearits proximal end. A related characteristic, “torqueability,” can be usedto describe the ability to rotate the catheter's distal end by rotatingits proximal end. “Flexibility,” particularly along a distal portion ofthe catheter, becomes increasingly important as the catheter enterswinding or tortuous passages. Other characteristics that become moreimportant with increased curvature of vascular passages include theability to resist kinking, tip damage (e.g., fraying or separating) andguidewire locking. Guidewire locking can occur when the tip member of acatheter deforms during rotation and locks onto an outer surface of aguidewire.

The present inventors recognize a difficulty in placing existing“push-to-advance” catheter designs, which include a relatively stiff,thick wall to navigate a vascular passage. The present inventors furtherrecognize that as higher demands for length have been placed oncatheters, a competing difficulty of smaller catheter distal endportions has developed. The present inventors also recognize thatcatheter threads configured to engage intraluminal lesions or vesselwalls may detach from the catheter body during operation, therebyleaving voids or pits where the threads were previously attached.

The present catheters overcome drawbacks of existing catheter designs byproviding a structure that, despite a reduction in distal diameter,maintains favorable structural properties and advanceability along itslength. A catheter can comprise an elongate shaft body and a tip memberdisposed at a distal end of the shaft body. The shaft body can extendfrom a proximal end to the distal end and can define an inner lumen. Theshaft body can include a liner, a braid member surrounding the liner, amulti-layer coil surrounding the braid member, and a polymer coversurrounding the multi-layer coil. An outer surface portion of thepolymer cover can include one or more helical threads. In an example,the one or more helical threads is positioned around a distal endportion of the shaft body and has a radial height sufficient to providea longitudinal pull on a vessel wall or a stenosis when rotated. The tipmember can be made from a metal or a polymer and can also include one ormore helical threads around its outer surface. Polymer tip members caninclude a distal tip comprised of a polymer having a durometer that ishigher than the rest of the tip member and/or lack a radiopaque fillermaterial. An outer wrapper can cover the polymer cover and the helicalthreads. Clinical bench testing has demonstrated that the presentcatheters exhibit pushability, flexibility, an ability to transfertorque in a controllable manner without kinking, tip damage or guidewirelocking, and an ability to be propelled along a blood vessel,particularly when rotated, without detachment of the helical threads.

The present methods can include advancing a distal end of a guidewire toa location proximate a stenosis or other narrowing in a blood vessel;guiding a catheter over the guidewire; using the guidewire as a rail,advancing a distal end of the catheter to the location proximate thestenosis or narrowing; rotating the catheter in a first direction andadvancing it into the stenosis or narrowing; and advancing the guidewirethrough the stenosis or narrowing with the support of the catheter. Theguidewire can be inserted into an inner lumen of the catheter, where theinner lumen is defined, in part, by a liner, a braid member surroundingthe liner, a multi-layer coil surrounding the braid member, and apolymer cover surrounding the multi-layer coil. Rotation of the catheterin the first direction can engage one or more helical threads on anouter surface of the polymer cover with the stenosis or wall of theblood vessel, which can help advance the catheter into and eventuallythrough the stenosis or narrowing.

These and other examples and features of the present catheters andmethods will be set forth, at least in part, in the following DetailedDescription. This Overview is intended to provide non-limiting examplesof the present subject matter—it is not intended to provide an exclusiveor exhaustive explanation. The Detailed Description below is included toprovide further information about the present catheters and methods.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, like numerals can be used to describe similar featuresand components throughout the several views. The drawings illustrategenerally, by way of example but not by way of limitation, variousembodiments discussed in the present patent document.

FIG. 1 illustrates a schematic view of a present catheter, asconstructed in accordance with at least one embodiment, located incoronary vasculature.

FIG. 2 illustrates a distal end portion of a present catheter, asconstructed in accordance with at least one embodiment, with one or morehelical threads located on both an outer surface of a shaft body and atip member being engaged with a vessel wall.

FIG. 3 illustrates partial, staggered cutaways of a present catheter, asconstructed in accordance with at least one embodiment.

FIG. 4 illustrates an enlarged side view of a distal end portion of apresent catheter's shaft body, as constructed in accordance with atleast one embodiment.

FIG. 5 illustrates a metallic tip member including one or more helicalthreads coupled with a distal end of a present catheter's shaft body, asconstructed in accordance with at least one embodiment.

FIG. 6 illustrates a metallic tip member including a smooth outersurface coupled with a distal end of a present catheter's shaft body, asconstructed in accordance with at least one embodiment.

FIG. 7 illustrates a polymer tip member including a non-tapered proximalportion, a tapered distal portion and a distal tip coupled with a distalend of a present catheter's shaft body, as constructed in accordancewith at least one embodiment.

FIG. 8 illustrates partial, staggered cutaways of portions of a presentcatheter's shaft body, as constructed in accordance with at least oneembodiment.

FIG. 9 illustrates a cross-section of a proximal end portion of apresent catheter's shaft body, such as a cross-section along line 9-9 ofFIG. 3.

FIG. 10 illustrates a cross-section of a distal end portion of a presentcatheter's shaft body, such as a cross-section along line 10-10 of FIG.3.

FIG. 11 illustrates a cross-section of a present catheter's polymer tipmember, such as a cross-section along line 11-11 of FIG. 3.

FIG. 12 illustrates a method of using a present catheter to navigatethrough vasculature, as constructed in accordance with at least oneembodiment.

FIG. 13 illustrates the stepwise addition of an outer wrapper to a shaftbody of a present catheter, as constructed in accordance with at leastone embodiment.

The drawing figures are not necessarily to scale. Certain features andcomponents may be shown exaggerated in scale or in schematic form andsome details may not be shown in the interest of clarity andconciseness.

DETAILED DESCRIPTION

FIG. 1 illustrates a present catheter 100 for supporting a guidewire 102or delivering a radiopaque, diagnostic or therapeutic agent through avessel stenosis or other tortuous anatomy of coronary vasculature 104,as constructed in accordance with at least one embodiment. The presentcatheter 100 can be used in peripheral and coronary applications.

The catheter 100 can include a shaft body 106 and a tip member 108 andcan be delivered through a surgically created opening in a femoral orradial artery, for example. The shaft body 106 can extend from aproximal end 110 to a distal end 112 and can define an inner lumen. Thetip member 108 can be connected to the distal end 112 of the shaft body106 and can include a lumen coaxial with the shaft body's inner lumen tofacilitate receipt or delivery of the guidewire or agent. A luer hub 114can be connected to the proximal end 110 of the shaft body 106 tofacilitate connection to other medical devices, such as valves, syringesor adaptors, and to provide access to the shaft body's inner lumen.

A proximal portion 116 of the shaft body 106 can be designed to be lessflexible than its distal portion 118. The less flexible proximal portion116 can provide enhanced axial and circumferential strength to thecatheter 100 for greater pushability and torqueability. The distalportion 118 can provide the catheter 100 with enhanced flexibility fornegotiating winding or tortuous vascular passages. An outer surfaceportion of the shaft body 106, such as the distal end portion 118, caninclude one or more helical threads 120 to enhance catheter delivery orwithdrawal through rotation.

FIG. 2 illustrates engagement between a vessel wall 226 and one or morehelical threads 220, 224 projecting from outer surfaces of a catheter'sshaft body 206 and tip member 208, respectively. A treating cliniciancan gently push the “rotate-to-advance” catheter 200 through vasculaturefar enough to engage the helical threads 220, 224 with the vessel wall226. The clinician can then rotate a proximal end of the catheter 200 inthe direction 228 of the helical threads, such as in a clockwisedirection, to advance the catheter through small and tortuous vessels toa target site. The helical threads 220, 224 can have a sufficient radialheight, relative to an outer surface of the shaft body 206 or tip member208, to provide a longitudinal pull on the vessel wall 226 or astenosis, if present, when rotated. The catheter 200 can be removed byrotating the proximal end of the catheter in a direction 230 oppositethe direction of delivery, such as in a counterclockwise direction. Insome examples, the catheter 200 may include helical threads 220 only onthe shaft body 206. In other examples, the helical threads 220 canextend along an outer surface portion of the tip member 208.

A side view of a catheter 300, including a shaft body 306 and a tipmember 308, is illustrated in FIG. 3. The shaft body 306 can includemultiple components, including an inner liner 332, a reinforcing braidmember 334, two coil layers 336, 338 wound in opposing directions, andan outer polymer cover 340. The braid member 334 can be composed ofmultiple elongate strands having a rectangular transverse profile andarranged with its thickness directed radially. Each coil layer 336, 338can be composed of multiple elongate stands having a fully-roundtransverse profile. The catheter 300 can optionally include a polymertip member 308 composed of a non-tapered proximal portion and a tapereddistal portion. The proximal portion of the tip member 308 (showncutaway) can receive distal ends of the braid member 334 and coil layers336, 338. Collectively, the sandwiching of the braid member 334 and coillayers 336, 338 between the inner liner 332 and the outer polymer cover340, and the polymer tip member's 308 receipt of distal ends of thebraid member 334 and the coil layers 336, 338 permits the catheter 300to be formed at a reduced thickness while maintaining favorablestructural characteristics including pushability, torqueability,flexibility and resistance to kinking.

FIG. 4 illustrates, in enlarged view, one or more helical threads 420 onan outer surface portion of a polymer cover 440, which can help propel acatheter through a blood vessel when rotated. A thin, outer wrapper 441can surround both the helical threads 420 and the polymer cover 440along a portion of the length of the shaft body 406. The outer wrapper441 can protect the threads 420 and prevent them from detaching duringrotation and intraluminal advancement of the catheter. The helicalthreads 420 can be positioned around a distal end portion 418 of a shaftbody 406 and project radially outward. Ends 442, 444 of the helicalthreads 420 can be tapered from zero to full height in one-half turn ofthe helix, for example, to facilitate gentle, gradual displacement of avessel wall or stenosis by the threads when the catheter is rotated foradvancement and retraction. Thread width 446 and thread pitch 448 can bedesigned so that the vessel wall or stenosis does not bridge betweenadjacent turns of the threads 420 but rather is only displaced in amanner closely conforming to the threads 420, thereby providing thenecessary longitudinal grip on the vessel wall or stenosis for advancingand retracting the catheter.

The outer wrapper 441 can provide a smooth protective layer between thethreads 420 and a lesion or vessel wall. As a result, the outer wrapper441 can improve the perfonnance of the catheter, especially when passingthrough dense, e.g., calcified, lesions by preventing the detachment ofthe threads during rotation therethrough. The protection provided by theouter wrapper 441 can allow increased distal extension of the helicalthreads 420 during construction of the catheter, which also increasesthe likelihood of the threads engaging a lesion.

The outer wrapper 441 can be any suitable material. In an embodiment,the outer wrapper 441 can be a thin-wailed, heat--shrink tubing. In anembodiment, the outer wrapper 441 can comprised of any suitablematerial, including various polymers, such as thermoplastic elastomers.In an embodiment, the outer wrapper 441 includes polyether block amide(commonly referred to as “PEBAX,” a registered trademark of ArkemaFrance Corporation). As shown in FIG. 4, the outer wrapper 441 can beconformed precisely to the shape of the polymer cover 440 and helicalthreads 420 such that the wrapper appears as an external coating on thecatheter body 406. In some examples, the thin-walled, heat-shrink tubingcan be cross-linked such that it shrinks, but does not melt, around thethreads 420 when heated. Such cross-linking can increase the strengthand/or melting temperature of the outer wrapper 441. The hardness of theouter wrapper 441 can vary, and can include any desired hardness orrange or ranges of hardness, including but not limited to ranging indurometer from about 45D to about 70D, about 50D to about 65D, about 55Dto about 63D, about 54D to about 56D, or about 62D to about 64D invarious embodiments.

In various examples, the one or more helical threads 420 includes apolymer member wound around the polymer cover 440. The polymer membercan be a strip of a synthetic fiber, such as nylon or polyester, havinga fully-round cross-sectional shape of about 0.05 mm-0.2 mm in diameterprior to being bonded to the polymer cover 440. The polymer member canhave a melting temperature higher than a melting temperature of thepolymer cover 440 so that the helical threads 420 can be thermallybonded to, and inlaid in, the polymer cover 440. Alternatively, thehelical threads 420 can be attached to the polymer cover 440 by sonic oradhesive bonding. The polymer member can, for example, extend 20-50turns around the outer surface of the polymer cover 440 at a uniformpitch of 1.0 mm-2.0 mm, resulting in a threaded section 2-8 cm inlength. Optionally, the polymer member can be reinforced with wire orfibers.

Hard, metallic tip members or softer, polymer tip members can beutilized by the present catheters and coupled to a distal end 112, 212,312, 512, 612, 712 of a shaft body 106, 206, 306, 506, 606, 706. FIGS.1, 2, 5 and 6 illustrate optional metallic tip members 108, 208, 508,608, and FIGS. 3 and 7 illustrate an optional polymer tip member 308,708.

Metallic tip members 108, 208, 508, 608 can facilitate crossing of adifficult stenosis or other narrowing and allow for imaging on a screenas a catheter advances through vasculature. In various examples, themetallic tip member 108, 208, 508, 608 includes a gold-plated, stainlesssteel member available with (FIGS. 1, 2 and 5) or without (FIG. 6) oneor more helical threads 224, 524. The gold-plating allows for imaging onthe screen. The helical threads 224, 524 can provide rotationaladvancement (in additional to the helical threads of the shaft body)through a vessel stenosis or other tortuous anatomy when the catheter isrotated. In some examples, the one or more helical threads 224, 524extends radially outward from an outer surface of the tip member 208,508; in other examples, the one or more helical threads extends radiallyinward from the outer surface and form a helical depression. Metallictip members 608 including a smooth outer surface (i.e., without threads)can be used in treatment cases benefiting from minimized friction duringcatheter advancement. In various examples, a proximal diameter of themetallic tip members can be in a range of 0.8 mm to 1.10 mm and a distaldiameter 509, 609 can be in a range of 0.50 mm to 0.80 mm, such as about0.70 mm. Polymer tip members 308, 708 can facilitate tracking throughtortuous vasculature using their inherent flexibility and low profile,including a distal diameter 709 in a range of 0.3 mm to 0.6 mm.

In the example of FIG. 7, the polymer tip member 708 includes anon-tapered proximal portion 750 and a tapered distal portion 752 thatculminates in a distal tip 754. The proximal portion 750 and the distalportion 752 can have a similar length, or the proximal portion 750 canbe longer than the distal portion 752. In an example, the polymer tipmember 708 has a length of 11 mm, including a 6-mm proximal portion 750and a 5-mm distal portion 752. One or more portions of the polymer tipmember 708 can be impregnated with a radiopaque filler material, such asbarium sulfate, bismuth trioxide, bismuth carbonate, powdered tungsten,powdered tantalum or like, so that its location within a subject's bodycan be radiographically visualized.

As further shown, the helical threads 520, 620, 720 of the shaft body506, 606, 706 can be covered by an outer wrapper 541, 641, 741. In someexamples, such as that shown in FIG. 7, the helical threads 720 canextend distally onto the non-tapered proximal portion 750 of the tipmember 708. In some embodiments, the threads 720 can extend distally onthe tip member 708 to about the point where the tapered distal portion752 begins.

The distal tip 754 can be made of a different material than theremainder of the proximal. portion 750 and/or the tapered distalportion. 752. In some embodiments, the distal tip 754 can have a greaterdurometer relative to the remainder of the tip member 708. For example,the distal tip 754 can be made of a thermoplastic elastomer, e.g.,PEBAX, with a suitable hardness. The hardness can be as desired, andcan, for example, range from about 35D to about 70D, about 35D to about40D, about 40D to about 45D, about 45D to about 55D, about 54D to about56D, or about 55D to about 65D. The present inventors recognize that,with the use of a stronger durometer polymer than the polymer formingthe proximal and intermediate portions of the tip member 708,deformation, separation or damage of the tip member 708 can be reducedduring operation, which also can reduce or eliminate locking of thedistal tip 754 onto the outer surface of a guidewire. In variousexamples, the distal tip 754 can also or alternatively lack a radiopaquefiller material, which, the present inventors have recognized, canreduce structural integrity of the tip making it more susceptible tofalling apart or separating when deformed. The length of the distal tip754, extending proximally from the most distal end of the tip member708, may be of any desired or suitable range, including ranging fromabout 0.5 mm to about 3.0 mm, about 1.0 mm to about 2.0 mm, about 1.4 mmto about 1.6 mm, or about 2.0 mm to about 3.0 mm.

In various embodiments, the polymer tip members 308, 708 can be formedby a die tipping process. Die tipping may require less manufacturingtime and generate less waste than other methods, e.g., laser tipping.Die tipping may also enhance manufacturing consistency, therebygenerating tip members of consistent flexibility and taper profiles, forexample.

FIG. 8 further illustrates the multiple components of a presentcatheter's shaft body 806, including a liner 832, a braid member 834,multiple coil layers 836, 838 and a polymer cover 840. The shaft body806 can define an inner lumen 860 and have an inner surface 854, anouter surface 856, a wall thickness 858 in a radial direction, and alength 859 of 60 cm-200 cm, for example.

The liner 832 can extend the length of the shaft body 806 and,optionally, into and through the catheter's tip member. The liner 832can be formed of a material providing high lubricity, such aspolytetrafluoroethylene (PTFE) or polyethylene, to reduce the forcesrequired to advance a guidewire or other member through an associatedcatheter.

Surrounding the liner 832 can be a braid member 834 formed of multipleelongate strands 862 wound helically in opposite directions andinterbraided with one another to form multiple crossings. The braidmember 834, like the liner 832, can extend the length of the shaft body806 and into the catheter's tip member. The strands 862 can be formed ofstainless steel or another high tensile strength material and can beaxially spaced apart to define multiple pies. The axial length of thepies, as determined by the strand spacing, can be selected to influenceone or more of the catheter's pushability, torqueability, flexibilityand kink resistance properties. The transverse profiles of the strands862, both as to surface area and as to the ratio of width-to-thickness,can also be selected to influence these characteristics. For example,structural strength can be increased by increasing the strand widthwhile maintaining the same thickness. Flexibility can be increased byincreasing the pie axial length. Another factor influencing the desiredcharacteristics is the braid angle of the filament strand windings,i.e., the angle of each helical strand 862 with respect to alongitudinal central axis. Increasing the braid angle tends to increasethe torqueability while reducing the pushability. In short, strands 862and arrangements of the strands 862 can be selected to customize thepresent catheter's properties.

In the example of FIG. 8, the braid member 834 includes 16 stainlesssteel strands 862 having a braid angle of 45 degrees along the axis ofthe catheter. Other braid angle ranges from 20 degrees to 60 degrees,for example, are also suitable. The braid member 834 can be stretchedaxially as it is placed upon the liner 832 during manufacture. When thecoil layers 836, 838 and the polymer cover 840 are placed over the braidmember 834, the braid member 834 can assume an unbiased configuration.In various examples, strands 862 of the braid member 834 can have athickness ranging from 0.010 mm to 0.015 mm, but both larger and smallerstrand thicknesses can also be used. Widths of the strands 862 can alsovary. Some embodiments use strand widths in the range of about 0.057 mmto 0.070 mm.

The multiple coil layers, which surround the braid member 834, caninclude a first coil layer 836 composed of one or more wires 864 woundin a first direction and a second coil layer 838 composed of one or morewires 866 wound in a second direction, opposing the first direction. Thesecond coil layer 838 can be positioned around and in contact with thefirst coil layer 836. In use, the wires 864, 866 of the first and secondcoil layers 836, 838 can interlock and provide the present catheter withbi-directional torqueability and pushability capabilities. For example,if one wire 864, 866 in a coil layer has a tendency to kink or bend inuse, particularly under influence of a load, the other wires 864, 866 inthe same layer or the adjacent layer can support it and inhibit kinking.

The wires 864, 866 can include a fully-rounded cross-section and canvary in size, number and pitch between the first coil layer 836 and thesecond coil layer 838 to alter structural properties of the catheter.Wire properties can be selected to balance structural properties, suchas pushability, torqueability and flexibility. In an example, each coillayer includes 12 wires having a diameter of about 0.050 mm. Each of the12 wires can have a uniform pitch that is equal to or greater than about0.623 mm. Adjacent wires of the 12-wire grouping can be view as having apitch that is equal to or greater than about 0.072 mm, with a small gapdistributed throughout each 12-wire grouping. The size of the pitch candepend on the diameter of the wires, the diameter of the inner lumen 860and the number of wires in the layer.

The polymer cover 840 can surround the coil layers 836, 838 and, inlight of the liner 832, can form the second of two polymer layersincluded in the shaft body 806. The polymer cover 840 can include alow-friction polymer, to reduce the forces required to advance thecatheter through vasculature, or a polymer with low viscosity at meltingtemperatures, to allow flow through and around the coil layers 836, 838and the braid member 834, the latter of which is shown in FIG. 9. In anexample, the polymer cover 840 is composed of polyether block amide(PEBAX). The polymer cover 840 can be applied to the coil layers 836,838 after they are wound into a tubular shape via an extrusion, moldingor shrink tubing process, and can be applied thicker along a proximalportion of the shaft body 806 than along a distal portion of the shaftbody to enhance distal flexibility and provide a smaller leading size.In an example, the proximal portion includes an outer diameter 909 (seeFIG. 9) between 0.9 mm-1.1 mm and the distal portion includes an outerdiameter 1009 (see FIG. 10) between 0.8-1.0 mm.

A hydrophilic coating can be provided on the outer surface 856 of theshaft body 806 for lubricious delivery and to aid in steerability. Thehydrophilic coating can be thin and constitute only a minor part of thewall thickness of the shaft body 806.

FIGS. 9 and 10 respectively illustrate cross-sections of a proximalportion and a distal portion of a shaft body 906, 1006, such as alonglines 9-9 and 10-10 of FIG. 3. As shown, a polymer cover 940, 1040 canextend inward and seal around first and second coil layers 936, 938,1036, 1038 and a braid member 934, 1034. Inherent elasticity of thepolymer cover 940, 1040 can allow wires 964, 966, 1064, 1066 of the coillayers 936, 938, 1036, 1038 to make small movements so that theflexibility of the coil layers is maintained; the elasticity also allowsthe shaft body wall to stay leak-proof when the wires move. The polymercover 940, 1040 can terminate at the distal end of the shaft body 906,1006, proximal to a tip member.

As further shown, an outer wrapper 1041 can fully envelop the polymercover 1040. Where helical threads are present, the outer wrapper 1041can envelop both the helical threads and the polymer cover 1040. In someexamples, the outer wrapper 1041 can terminate at the distal end of theshaft body 1006, proximal to the end of the shaft body 1006, or on thetip member. The cross-sectional thickness of the outer wrapper 1041 canvary and can be of any desired dimensions, including ranging from about0.01 mm to about 0.5 mm, about 0.05 mm to about 0.3 mm, or about 0.1 mmto about 0.2 mm.

FIG. 11 illustrates a cross-section of a proximal portion of a tipmember 1108, and specifically a polymer tip member, which is coupledwith a distal end of a shaft body. Distal ends of first and second coillayers 1136, 1138, a braid member 1134 and a liner 1132 can extend intothe tip member 1108 and can be surrounded by a polymer impregnated witha radiopaque material. The polymer 1168 of the tip member 1108 can havea higher viscosity at melting temperatures such that little to no flowthrough or around the coil layers 1136, 1138 or the braid member 1134occurs. In an example, the polymer of the tip member is pellethane andthe void space 1170 existing within the polymer 1168 can provide thecatheter's distal end portion with increased flexibility relative to theshaft body.

FIG. 12 illustrates a method 1272 of using a present catheter tonavigate through vasculature, as constructed in accordance with at leastone embodiment.

At step 1274, the method can include advancing a distal end of aguidewire through vasculature to a location proximate a stenosis orother narrowing in a blood vessel. At step 1276, a catheter can beguided over the guidewire by inserting its proximal end into an innerlumen of the catheter from the catheter's distal end. The inner lumencan be defined, in part, by a liner, a braid member surrounding theliner, a multi-layer coil surrounding the braid member, and a polymercover surrounding the multi-layer coil. Using the guidewire as a rail, adistal end of the catheter can be advanced to the location proximate thestenosis or narrowing at step 1278.

The catheter can be rotated in a first direction at step 1280, therebyengaging one or more helical threads on an outer surface of the polymercover with the stenosis or wall of the blood vessel. An outer wrappersurrounding the helical threads and outer surface of the polymer covercan protect the helical threads from detachment or loosening duringengagement with the stenosis or blood vessel wall.

This engagement between the helical threads and the stenosis or vesselwall can propel the catheter forward, in a distal direction. Incrementalrotation of the catheter, particularly the catheter's proximal end, canallow incremental movement of the catheter relative to the stenosis orvessel wall. At step 1282, the guidewire can be advanced distally withthe support of the catheter. The method can be configured such that thedistal end of the guidewire is at all times distal to the distal end ofthe catheter. In some examples, the catheter's tip member may include ahard or semi-hard distal tip, which can prevent its deformation,separation or other damage during rotation through the blood vessel, andfurther prevent the tip member from locking with an outer surface of theguidewire.

The catheter can be withdrawn from the blood vessel at step 1284 byrotating its proximal end in a second direction, opposite the firstdirection. Rotation of the catheter, whether in the first direction orthe second direction, can cause wires of the first and second coillayers to engage.

Additional method steps are also possible. At step 1286, the method canoptionally include viewing a tip member using an imaging means. At step1288, the method can optionally include delivering a radiopaque,diagnostic or therapeutic agent through the inner lumen of the catheter.And at step 1290, the method can optionally include exchanging theguidewire advanced to the location proximate the stenosis or narrowingwith a second guidewire.

FIG. 13 illustrates the stepwise addition of an outer wrapper 1341 tothe shaft body 1306 of a present catheter.

At step 1374, the outer wrapper 1341 may be slid over the shaft body1306 in the direction of the arrow until the wrapper circumferentiallysurrounds the helical threads 1320. Prior to heating, the outer wrapper1341 may be in the form of a rigid or semi-rigid tube having a diameterslightly greater than the thread-wrapped portion of the catheter. Thelength of the outer wrapper 1341 can approximately match the length ofthe shaft body 1306 that is wrapped in helical threads 1320. In someexamples, the length of the outer wrapper 1341 can be greater than thethreaded portion of the shaft body, such that the outer wrapper extendsproximally and/or distally from the helical threads 1320, and in somecases, onto the tip member 1308.

At step 1376, the outer wrapper 1341 may be heated, thereby causing thewrapper to shrink until it conforms tightly to the exterior of thethreaded portion of the shaft body 1306. The temperature necessary toshrink the outer wrapper 1341 around the shaft body 1306 can range,including from about 260° F. to about 360° F., about 280° F. to about355° F., about 300° F. to about 350° F., about 320° F. to about 340° F.,or about 330° F. to about 340° F., for example, depending on theparticular material used.

At step 1378, the outer wrapper can be allowed to cool and harden aroundthe shaft body 1306. In an embodiment, the outer wrapper 1341 can bethin and transparent, such that after heating, the portion of the shaftbody 1306 covered by the outer wrapper remains visible. In anembodiment, the outer wrapper 1341 can have a smooth and glossy finishto facilitate sliding and rotating through a vessel lumen.

Closing Notes:

The present catheters and methods include or use a multi-component shaftbody, which can include one or more helical threads projecting from itsouter surface. The multi-component shaft body can provide catheters withfavorable structural characteristics including pushability,torqueability, flexibility and resistance to kinking, guidewire lockingand thread detachment. First and second helically-wound coil layers ofthe shaft body, for example, can provide torqueability and pushabilityto the catheter. A braid member can enable a small shaft body diameterfor extending through a tortuous path and reaching small vessels and canfurther provide kink resistance. The one or more helical threads canprovide the catheter with a rotationally-activated propulsion means. Anouter wrapper can protect the helical threads from damage or dislodgmentduring propulsion. A hard or semi-hard distal tip can be resistant todeformation during lesion engagement. Accordingly, the present cathetersand methods can overcome difficulties associated with placing existing“push-to-advance” catheter designs and can possess a small cross-sectionto navigate tortuous anatomy.

The above Detailed Description includes references to the accompanyingdrawings, which form a part of the Detailed Description. The DetailedDescription should be read with reference to the drawings. The drawingsshow, by way of illustration, specific embodiments in which the presentcatheters and methods can be practiced. These embodiments are alsoreferred to herein as “examples.”

The above Detailed Description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or morefeatures or components thereof) can be used in combination with eachother. Other embodiments can be used, such as by one of ordinary skillin the art upon reviewing the above Detailed Description. Also, variousfeatures or components can be grouped together to streamline thedisclosure. This should not be interpreted as intending that anunclaimed disclosed feature is essential to any claim. Rather, inventivesubject matter can lie in less than all features of a particulardisclosed embodiment. Thus, the following claim examples are herebyincorporated into the Detailed Description, with each example standingon its own as a separate embodiment:

In Example 1, a catheter can comprise an elongate shaft body and a tipmember disposed at a distal end of the shaft body. The shaft body canextend from a proximal end to the distal end and can define an innerlumen. The shaft body can include a liner, a braid or coil surroundingthe liner, and a polymer cover surrounding the braid or coil. An outersurface portion of the polymer cover can include one or more helicalthreads. An outer wrapper can cover the distal outer surface portion ofthe polymer cover and the one or more helical threads. A tip member canbe disposed at the distal end of the shaft body.

In Example 2, the catheter of Example 1 can optionally be configuredsuch that the tip member includes a polymer tip member having a distaltip.

In Example 3, the catheter of Example 2 can optionally be configuredsuch that proximal and intermediate portions of the tip member areloaded with a radiopaque filler material, and the distal tip lacks theradiopaque filler material.

In Example 4, the catheter of any one of Examples 2-3 can optionally beconfigured such that the tip member includes a distal tip comprised of apolymer having a durometer of about 50D to about 60D.

In Example 5, the catheter of Example 4 can optionally be configuredsuch that the polymer of the distal tip is a thermoplastic elastomer.

In Example 6, the catheter of any one of Examples 4-5 can optionally beconfigured such that the distal tip has a length of about 1 mm to about2 mm.

In Example 7, the catheter of any one or any combination of Examples 2-6can optionally be configured such that the distal tip has a length ofabout 1 mm to about 2 mm.

In Example 8, the catheter of any one or any combination of Examples 2-7can optionally be configured such that the polymer tip member includes anon-tapered proximal portion and a tapered distal portion.

In Example 9, the catheter of Example 8 can optionally be configuredsuch that the one or more helical threads extends onto the non-taperedproximal portion of the polymer tip member.

In Example 10, the catheter of Example 9 can optionally be configuredsuch that the one or more helical threads extends to a junction betweenthe non-tapered proximal portion and the tapered distal portion.

In Example 11, the catheter of any one or any combination of Examples8-10 can optionally be configured such that the outer wrapper extends tothe junction between the non-tapered proximal portion and the tapereddistal portion.

In Example 12, the catheter of any one or any combination of Examples1-11 can optionally be configured such that the outer wrapper comprisesa thermoplastic elastomer configured to shrink upon heating.

In Example 13, the catheter of Example 12 can optionally be configuredsuch that the thermoplastic elastomer has a durometer of about 50D toabout 60D.

In Example 14, the catheter of any one of Examples 12-13 can optionallybe configured such that a melting temperature of the thermoplasticelastomer is about 260° F. to about 360° F.

In Example 15, the catheter of any one or any combination of Examples1-14 can optionally be configured such that the one or more helicalthreads includes a polymer member wound around the polymer cover.

In Example 16, a catheter can comprise an elongate shaft body extendingfrom a proximal end to a distal end and defining an inner lumen. Theshaft body can include a liner, a multi-layer coil surrounding theliner, and a polymer cover surrounding the multi-layer coil. Thecatheter can include a distal outer surface portion of the polymer coverof the shaft body including one or more helical threads. The cathetercan include a tip member disposed at the distal end of the shaft body.The tip member can include a distal tip comprised of a polymer having ahardness greater than that of a remainder of the tip member.

In Example 17, the catheter of Example 16 can optionally be configuredsuch that the distal tip has a durometer of about 50D to about 60D and alength of about 1 mm to about 2 mm.

In Example 18, the catheter of Example 17 can optionally be configuredsuch that the distal tip is comprised of PEBAX.

In Example 19, the catheter of any one or any combination of Examples16-18 can optionally be configured to include an outer wrapper coveringthe distal outer surface portion of the polymer cover and the one ormore helical threads.

In Example 20, the catheter of Example 19 can optionally be configuredsuch that the outer wrapper is comprised of PEBAX and has a durometer ofabout 50D to about 60D.

In Example 21, the catheter of any one or any combination of Examples1-20 can optionally be configured such that all components or optionsrecited are available to use or select from.

Certain terms are used throughout this patent document to refer toparticular features or components. As one skilled in the artappreciates, different people may refer to the same feature or componentby different names. This patent document does not intend to distinguishbetween components or features that differ in name but not in function.

For the following defined terms, certain definitions shall be appliedunless a different definition is given elsewhere in this patentdocument. The terms “a,” “an,” and “the” are used to include one or morethan one, independent of any other instances or usages of “at least one”or “one or more.” The term “or” is used to refer to a nonexclusive or,such that “A or B” includes “A but not B,” “B but not A,” and “A and B.”All numeric values are assumed to be modified by the term “about,”whether or not explicitly indicated. The term “about” generally refersto a range of numbers that one of skill in the art would considerequivalent to the recited value (e.g., having the same function orresult). In many instances, the term “about” can include numbers thatare rounded to the nearest significant figure. The recitation ofnumerical ranges by endpoints includes all numbers and sub-ranges withinand bounding that range (e.g., 1 to 4 includes 1, 1.5, 1.75, 2, 2.3,2.6, 2.9, etc. and 1 to 1.5, 1 to 2, 1 to 3, 2 to 3.5, 2 to 4, 3 to 4,etc.). The terms “patient” and “subject” are intended to includemammals, such as for human or veterinary applications. The terms“distal” and “proximal” are used to refer to a position or directionrelative to the treating clinician. “Distal” and “distally” refer to aposition that is distant from, or in a direction away from, the treatingclinician. “Proximal” and “proximally” refer to a position that is near,or in a direction toward, the treating clinician.

The scope of the invention should be determined with reference to theappended claims, along with the full scope of equivalents to which suchclaims are entitled. In the appended claims, the terms “including” and“in which” are used as the plain-English equivalents of the respectiveterms “comprising” and “wherein.” Also, in the following claims, theterms “including” and “comprising” are open-ended; that is, a device,kit or method that includes features or components in addition to thoselisted after such a term in a claim are still deemed to fall within thescope of that claim. Moreover, in the following claims, the terms“first,” “second” and “third,” etc. are used merely as labels, and arenot intended to impose numerical requirements on their objects.

The Abstract is provided to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims.

1. A catheter, comprising: an elongate shaft body extending from aproximal end to a distal end and defining an inner lumen, the shaft bodyincluding a liner, a braid or coil surrounding the liner, and a polymercover surrounding the braid or coil; a distal outer surface portion ofthe polymer cover of the shaft body including one or more helicalthreads configured to urge movement of the shaft body within vasculaturevia rotation applied to the shaft body' s proximal end; an outer wrappercovering the distal outer surface portion of the polymer cover and theone or more helical threads; and a tip member disposed at the distal endof the shaft body.
 2. The catheter of claim 1, wherein the tip memberincludes a polymer tip member having a distal tip.
 3. The catheter ofclaim 2, wherein proximal and intermediate portions of the tip memberare loaded with a radiopaque filler material, and wherein the distal tiplacks the radiopaque filler material.
 4. The catheter of claim 2,wherein the distal tip is comprised of a polymer having a durometer ofabout 50D to about 60D.
 5. The catheter of claim 4, wherein the polymerof the distal tip is a thermoplastic elastomer.
 6. The catheter of claim4, wherein the durometer of the distal tip is greater than a durometerof a remainder of the tip member.
 7. The catheter of claim 2, whereinthe distal tip has a length of about 1 mm to about 2 mm.
 8. The catheterof claim 2, wherein the polymer tip member includes a non-taperedproximal portion and a tapered distal portion.
 9. The catheter of claim8, wherein the one or more helical threads extends onto the non-taperedproximal portion of the polymer tip member.
 10. The catheter of claim 9,wherein the one or more helical threads extends to a junction betweenthe non-tapered proximal portion and the tapered distal portion.
 11. Thecatheter of claim 10, wherein the outer wrapper extends to the junctionbetween the non-tapered proximal portion and the tapered distal portion.12. The catheter of claim 1, wherein the outer wrapper comprises athermoplastic elastomer configured to shrink upon heating.
 13. Thecatheter of claim 12, wherein the thermoplastic elastomer has adurometer of about 50D to about 60D.
 14. The catheter of claim 12,wherein a melting temperature of the thermoplastic elastomer is about260° F. to about 360° F.
 15. The catheter of claim 1, wherein the one ormore helical threads includes a polymer member wound around the polymercover.
 16. (canceled)
 17. The catheter of claim 2, wherein the distaltip has a durometer of about 50D to about 60D and a length of about 1 mmto about 2 mm.
 18. The catheter of claim 2, wherein the distal tip iscomprised of PEBAX.
 19. (canceled)
 20. The catheter of claim 1, whereinthe outer wrapper is comprised of PEBAX and has a durometer of about 50Dto about 60D.